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Cannabis Cannabinoid Res. 2016 Dec 1;1(1):244-251. doi: 10.1089/can.2016.0024. eCollection 2016.

Training and Practices of Cannabis Dispensary Staff.

Author information

PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, California.
National Center for PTSD, VA Palo Alto Healthcare System, Palo Alto, California.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California.
Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VAMC, Philadelphia, Pennsylvania.
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.


Introduction: The proliferation of cannabis dispensaries within the United States has emerged from patient demand for the legalization of cannabis as an alternative treatment for a number of conditions and symptoms. Unfortunately, nothing is known about the practices of dispensary staff with respect to recommendation of cannabis strains/concentrations for specific patient ailments. To address this limitation, the present study assessed the training and practices of cannabis dispensary staff. Materials and Methods: Medical and nonmedical dispensary staff (n=55) were recruited via e-mail and social media to complete an online survey assessing their demographic characteristics, dispensary features, patient characteristics, formal training, and cannabis recommendation practices. Results: Fifty-five percent of dispensary staff reported some formal training for their position, with 20% reporting medical/scientific training. A majority (94%) indicated that they provide specific cannabis advice to patients. In terms of strains, dispensary staff trended toward recommendations of Indica for anxiety, chronic pain, insomnia, nightmares, and Tourette's syndrome. They were more likely to recommend Indica and hybrid plants for post-traumatic stress disorder (PTSD)/trauma and muscle spasms. In contrast, staff were less likely to recommend Indica for depression; hybrid strains were most often recommended for amyotrophic lateral sclerosis (ALS). In terms of cannabinoid concentrations, dispensary staff were most likely to recommend a 1:1 ratio of delta-9-tetrahydrocannabinol (THC):cannabidiol (CBD) for patients suffering from anxiety, Crohn's disease, hepatitis C, and PTSD/trauma, while patients seeking appetite stimulation were most likely to be recommended THC. Staff recommended high CBD for arthritis and Alzheimer's disease and a high CBD or 1:1 ratio for ALS, epilepsy, and muscle spasms. Conclusions: Although many dispensary staff are making recommendations consistent with current evidence, some are recommending cannabis that has either not been shown effective for, or could exacerbate, a patient's condition. Findings underscore the importance of consistent, evidence-based, training of dispensary staff who provide specific recommendations for patient medical conditions.


cannabis; dispensary; marijuana; practices

Conflict of interest statement

Drs. Bonn-Miller and Vandrey serve as consultants for CW Botanicals, Insys Therapeutics, and Zynerba Pharmaceuticals. Dr. Bonn-Miller also consults for Tilray (a division of Privateer Holdings). Dr. Babson served as a consultant for Insys Therapeutics. None of the above entities was involved with the design, implementation, analysis, or dissemination of the present study. The expressed views do not necessarily represent those of the Department of Veterans Affairs.

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